HePAG response to recent draft NICE guidelines on Low back pain and Sciatica

We are disappointed with the recently published draft NICE Guidelines for Low Back Pain and Sciatica, in which acupuncture is no longer recommended for the treatment of these conditions. This sees a transformation from the 2009 NICE guidelines for low back pain, in which a course of acupuncture needling was recommended for those with back pain persisting beyond six weeks.

We feel that NICE have failed to properly evaluate the comparison between acupuncture treatment and other treatments commonly used for these conditions. Many of the studies referenced, compare acupuncture to sham-acupuncture, a clinically irrelevant comparison as this is not viewed as an appropriate placebo. By doing so, we feel that NICE have not assessed the effectiveness of acupuncture in a clinically relevant manner.

A publication produced by the Acupuncture Association of Chartered Physiotherapists (AACP), ‘The Evidence’, does achieve this. The evidence collated in this document demonstrates high-quality scientific research in support of the use of acupuncture for acute LBP and chronic non-specific LBP. After review of the available evidence the AACP will continue to recommend the consideration of acupuncture as a treatment option for patients suffering low back pain. HePAG also encourages our members to remember the principles of evidence based medicine, which is defined as the integration of best research evidence with clinical expertise and patient values and choice.

Low back pain not only impacts the individual’s quality of life, it is also a socioeconomic problem associated with work absenteeism, disablement and high healthcare costs (Van Tulder, 2006). According to the Office of National Statistics (ONS) work related low back pain is a major ill health condition in Great Britain, with 2,957,000 working days lost in the 2014/15 financial year alone. Given this impact across both the individual’s quality of life as well as the Great British economy, it will be detrimental to remove a safe, effective and low-cost treatment option for patients and medical professionals.

Other bodies such as the Scottish Intercollegiate Guidelines Network (SIGN, 2013) and many European and International scientific bodies continue to support the use of acupuncture for the treatment of LBP. Including the World Health Organisation, which lists low back pain and sciatica as conditions for which acupuncture has been proved – through controlled trials – to be an effective treatment.

The guideline is now open for consultation and will close on 5th May 2016 at 5pm. We will continue to support not only our members, but also their patients’ choice.

You can make your voice heard by signing this online petition to NICE, click here to sign the petition today.